Nutrient modulation of inflammatory and immune function

Cerra, Frank B.

doi:10.1016/0002-9610(91)91136-7

Cited by 46 publications

(11 citation statements)

References 14 publications

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“…The effects are mediated through effects on the immune response, induction of anabolic hormone secretion and nutritional effects (329). Recently, purines and pyrimidines, precursors of DNA and RNA, have gained increasing interest as modulators of immune responses in surgical patients (330). It has been reported that enteral nutrition with supplemental arginine, RNA and omega-3-fatty acids compared with standard enteral diet markedly improved immune and metabolic outcome and recovery from surgery (331).…”

Section: G Nutritional Aspectsmentioning

confidence: 99%

Effects of anaesthesia and surgery on the immune response

Salo

1992

Acta Anaesthesiol Scand

309

171

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Alterations have been found to occur in every component of immune response during anaesthesia and surgery. These alterations represent the body's general physiological responses and are mainly dependent on the extent of surgery, as well as other factors such as the patient's age and health status, medication and blood transfusion. Anaesthetic and operative complications have profound effects on these responses. Basically, the immune response to anaesthesia and surgery is a beneficial reaction, needed in local host defences and wound healing and in preventing the body from making autoantibodies against its own tissues. The responses may, however, contribute to the development of postoperative infections and spread of malignant disease. During uncomplicated conventional surgery, the immune response usually passes clinically unnoticed without any harmful effects. Absent responses and excessively high responses, on the other hand, harm the patient. Our understanding of immunological phenomena and our possibilities of controlling mediator activation are now lagging behind the technical advances made in operative treatment. If we want to decrease operative morbidity and mortality to below their present levels, more attention should be directed to immune responses to major surgery, injuries and operative complications with massive mediator release which place the surgical patient at risk. Experimental evidence suggests that results of treatment in injured and operated patients can in the future be improved by controlling immune responses and their mediator systems. Our current level of knowledge of immune responses is already helping us to avoid many immune-mediated complications. However, routine interference with these responses is not indicated.

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Section: G Nutritional Aspectsmentioning

confidence: 99%

Effects of anaesthesia and surgery on the immune response

Salo

1992

Acta Anaesthesiol Scand

309

171

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“…Although some beneficial effects have been reported, (17) the specific effect of these anticytokines on ARDS has not been established. ANTIOXIDANTS The clearer understanding that lung and systemic antioxidants are decreased in critical illness has made exogenous replacement of nonenzymatic antioxidants a part of standard critical care management (18,19). Current treatment recommendations are 100 mg selenium, 1 g ascorbic acid, and 400 IU vitamin E per day.…”

Section: Pharmacologic Modalitiesmentioning

confidence: 99%

The Modern Version of Adult Respiratory Distress Syndrome

Demling

1995

Annu. Rev. Med.

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Adult respiratory distress syndrome (ARDS) remains a highly lethal complication of autodestructive inflammation. This syndrome originally referred to a single organ failure but is now considered a component, usually the first, of the multisystem organ failure syndrome (MOFS). Cytokines, neutrophils, and endothelial adherence molecules initiate the disease process, with cell injury caused by oxidants and proteases released from inflammatory cells. ARDS, if progressive, will result in pulmonary fibrosis. Improved ventilatory support techniques have not been shown to decrease mortality. Pharmacologic manipulation of the inflammatory response is a more promising method of controlling the disease process.

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“…Enteral formulations have developed to such an extent that they contain selected substrates such as glutamine, nucleotides, arginine and n-3 fatty acids as well as selenium, vitamins E, C, A and beta-carotene in supra normal concentrations. Clinical demonstration of the enhancing action of these immune-modulating diets on individual parameters of cellular defense has already been successful, with patients mostly examined during postoperative or post-traumatic stress (Cerra, 1991;Daly et al 1992;Kemen et al 1995;Moore et al 1994). However, a modifying effect on selected parameters of the immune response does not, in itself, justify the use of an expensive enteral nutritional formula that may not be free from sideeffects.…”

Section: Introductionmentioning

confidence: 99%